Introduction
Contaminated water and soil are the primary sources of Lead poisoning. Color materials, cosmetics, kohl eye, fake lipstick, and contaminated opium are known as common sources. These are considered causes of lead poisoning [1]. Lead toxicity with ”Swamp stone” or ”Silver stone” rarely occurs [2]. In most Iranian perfumery stores, this material is sold under the name ”Sang-e-Mordab.” It is a yellow to brown powder, rubbed on the skin as a deodorant to remove the smell of underarm odor, sweaty feet, and reduce sweating. Swamp stone consists of nearly 70 percent heavy metals, mostly lead oxide (Pbo), and it also contains a low amount of other metals such as Chromium and Nickle. Skin, lungs, and GI tracts can absorb lead oxide. Excessive use or ingestion of this powder can result in lead poisoning. Such material is dangerous if used carelessly.
Lead can affect the central and peripheral nervous system, skin, kidneys, reproductive system, gastrointestinal system, and musculoskeletal system. Patients with high blood lead levels (BLL) may experience severe, intractable abdominal colic pain (very common), weakness, paralysis anemia, high blood pressure, and renal dysfunction [3]. Asymptomatic lead poisoning has become more common in children. High lead levels in children affect neurocognition and behavioral development that could be irreversible [4]. In adults, high blood lead level is associated with memory deficit and loss of attention [5].
Recently, United States experienced a lead poisoning disaster in Michigan. This public health disaster happened when Flint changed its water source and led leached into aging pipes’ water supply. As a result, heavy metal levels in drinking water became significantly elevated [6].
Based on the World Health Organization declaration and the Centers for Disease Control and Prevention, there is no safe level of blood lead [7]. Some countries over the years have developed guidelines to manage lead intoxicated patients better, but there is no official organization in Iran for investigating and treating lead poisoning. The average lead level in the Iranian population is not well studied. Therefore, practitioners face many difficulties while diagnosing and treating these patients. This case report presents a family of five with different signs and symptoms but the same diagnosis.